In an Attempt Not to Bias Readers, the Doctor Character Doesn't Get Named until the End. Also: Sorry, This is a Long One

Scene: midday Monday at the offices of The Fertility Institute at Posh Hospital; a slightly nervous couple waits to speak about IVF with a doctor they have never met

Doctor: Hi, nice to see you. (shakes hands) So, why hasn't this worked yet?

Andrea: That's what we'd like to know.

Doctor: Well, we can't tell. You're young. All your numbers look great. You've had a number of mature follicles every cycle. Your sperms counts are fine. But IUIs only give a 17-18% chance of pregnancy. IVF, for patients your age, has a 70% success rate. So I really want to push things. I want to increase your dosage and get as many eggs as we can.

Andrea: But...

Doctor: Then I'm going to say we do IVF with ICSI. (spelling it out and speaking slowly while writing on a chart) That's intra... cytoplasmic... sperm... injection...

Andrea: Yes, we know. We've actually done two IVF cycles with ICSI at a previous clinic. (thinking to herself, "It's all in that fat stack of patient records you're holding; have you glanced at those?")

Doctor: Oh. (glancing at papers) I see that.

Andrea: When we did IVF before, we only...

Doctor: (back to the chart he's writing out) So we're going to run a bunch of tests first, to make sure we don't miss anything and we have the best chance of making this work. We'll do a Clomid Challenge Test, to determine the best dose of medications for you. We'll do some bloodwork to check for antibodies that would fight against pregnancy, and for blood-clotting disorders. We'll do one test - and this one isn't covered by insurance - to check for enzymes in your endometrial lining that would support a pregnancy.

Andrea: Okay, all those tests sound fine. But you should know, we don't want to freeze or discard any embryos. We want to fertilize a small number of eggs and transfer all the viable embryos.

(silence)

Doctor: Boy, kids. That really, I mean really lowers your success rates to almost nothing. I mean, I understand, I respect where you're coming from. But if you don't give me any out, I can only let you fertilize three eggs. What if they all fertilize? Three embryos is the most I'd be comfortable to transfer, and I can't take the risk of you having more than that.

Andrea: Well, when we talked about all this with Dr. Owlish, he told us that only one out of every five eggs has the genetic material to turn into a viable pregnancy. So he suggested we fertilize 6-8 eggs.

Doctor: Hmm, Dr. Owlish is usually more conservative than me. I can't let you do more than three. What if we end up with four embryos, and you have quadruplets? They'd probably have all sorts of disabilities. They wouldn't be able to take care of themselves, you wouldn't be able to train them. I would haunt you for the rest of your lives. Your lives would be a living hell.

Aaron & Andrea: ... Um, we know the concerns, but our history...

Doctor: I know my numbers. I can't do more than three.

Andrea: Look, we don't want high order multiples, either. But we fertilized four eggs at our previous clinic, and we only ended up with two embryos for a day 3 transfer for our first cycle, and one embryos that barely made it to blasocyst for a day 6 transfer for our second cycle. So doesn't that show...

Doctor: I know my numbers. We're better than your previous clinic. We have much higher pregnancy rates.

Aaron: But doesn't our track record have an influence?

Doctor: Every cycle is different. I know my numbers.

Andrea: So why, if we know fertilizing four of our eggs in the past did not result in four embryos to transfer, would it be different here?

Doctor: Better eggs. Better lab.

Andrea: Well, have you worked with patients who only fertilized three eggs before? What were the results?

Doctor: It runs the gamut. Some end up pregnant. Some don't make it to transfer. We don't have many patients who restrict us this way. I respect your position, but you have to respect that I know my numbers. I can't do more than three. You might be able to find another doctor in this area that would work with you, that would let you fertilize more eggs, but they don't have the success rates that I do. I'm sorry, kids; I know this isn't what you want to hear.

Andrea: (this is going nowhere; let's change the subject) So, we run all these tests during one cycle?

Doctor: Yes. (standing up to leave) So call on day one and we'll get you started.

Aaron & Andrea: Wait! Dr. Owlish also suggested donor embryos?

Doctor: Hmm, that's really rare. Nobody wants to do that.

Aaron & Andrea: more questions...

Doctor: more non-answers... Good luck! (exit)

(end scene)


So, how do you interpret the conversation? We were less than pleased. Whether he's right or wrong about the number of eggs we should fertilize (and I'm inclined to think he's wrong, because we know what happened with four eggs fertilized), he is not the kind of doctor I feel comfortable working with. Though this was the first time we met, he didn't do any introductions and he never addressed us by name. He didn't really listen to anything we said, and he seems far more concerned with his precious numbers than with the individual patients sitting in front of him. I'm trying, with mixed success, not to be angry at this doctor. I'm glad that my confidence is not in doctors but in God, who does hear me. Our plan, at this point, is to go ahead with all the tests (doesn't hurt to gather more information) while researching other doctors in the area and considering our next steps.

Oh, and I think the blog nickname for this particular medical professional will be Dr. Ego.

31 Words

I was tagged by Mustard Seed Baby for this post. The rules state that I should answer each question with one word. I might cheat by hyphenating some!

1. Where is your cell phone? windowsill
2. Your significant other? charming
3. Your hair? wavy
4. Your mother? Dutch
5. Your father? Dutch
6. Your favorite thing? books
7. Your dream last night? none
8. Your favorite drink? properly-prepared-tea
9. Your dream/goal? heaven
10. The room you're in? home-office
11. Your hobby? blogging!
12. Your fear? chidlessness
13. Where to you want to be in six years? here
14. What you're not? extroverted
15. Muffins? blueberry
16. One of your wish list items? this
17. Where you grew up? everywhere
18. The last thing you did? laundry
19. What are you wearing? skirt
20. Favorite gadget? immersion-blender
21. Your pet? none
22. Your computer? laptop
23. Your mood? weekend-ready
24. Missing someone? Wacoans
25. Your car? Ion
26. Something you are not wearing? socks
27. Favorite store? Ann-Taylor-Loft
28. Like someone? Michael Kitchen
29. Your favorite color? green
30. When is the last time you laughed? morning
31. Last time you cried? July?

Consider yourself tagged if you read this and want to give it a try. Happy weekend!

He Knows. He's Good.

"...then the Lord knows how to rescue the godly from trials..." (2 Peter 2:9)

I read that verse on Monday morning, before going in for my beta but knowing the results would likely be negative. That phrase, "then the Lord knows how to rescue the godly from trials," is one full of implicit questions and answers about suffering.

When faced with affliction, most of us wrestle with challenging questions. Why has God let this happen? Why won't God stop this, take this pain away? Can God control the sorrow that batters me? If he can but doesn't, can I trust him?

We need, I need, to hold tightly to two handles. The first handle is God's sovereignty, his powerful ability to control all things in heaven and on earth. Nothing happens apart from his decision. The second handle is God's goodness. Many of us only have a grip on that second handle. I think that, within contemporary Christianity at least, the most common answer to questions about suffering is that God is good and loving and would put an end to all our problems if he could, but, well, he's just not strong enough to do that. I understand how alluring that seeming solution is, but that? Isn't God. And it's ultimately a sloppy sop of comfort. If God is powerful but not good, we're all in trouble. If God is kindly but impotent, our trials are hopeless. But, praise him, he is both! He is King, and he is Love. When I suffer, I have to hang on to both handles of God's sovereignty and goodness, dangling in the paradox of the space between them, mid-air in affliction but sure of the One to whom my soul clings.

The Lord knows how to rescue the godly from trials. I am not stuck in the maze of infertility, following a God who doesn't know the way, can't see around the walls, and keeps running into dead ends. He knows how to get me out. He hasn't yet, but that's not because he takes sadistic pleasure in watching me scurry from bend to bend, corner to corner. It's because he knows the best way to rescue me. That way may be longer and have more twists than I would like, but the path that looks quickest and easiest to me would get me lost. He made the maze, and he'll lead me through it and out of it. He knows how to rescue me, and at just the right time, he will. He is a proven, wise, compassionate rescuer.

The Lord knows how to rescue the godly from trials. He knows, and he's putting that knowledge to good use.

We Called It "The Dress Car." Because It Was So Fancy.

Back in June, I wrote about how my first response to a day full of challenges was, "What next, Lord? Are you going to cause one of our cars to explode?..." Well, it turns out that was a strangely prescient though not altogether accurate thought. Today we found out that one of our cars was in fact on the brink of exploding!

Aaron's car had a leaking tire on Friday. He filled it with that fix-a-flat stuff and drove it home from work, but he noticed that it seemed wobblier than usual. Usual being not-wobbly, except when you go over a bump in the road. So we got a recommendation for a mechanic near our new home and made an appointment. "Brake problems," we thought, "or maybe suspension." Then the mechanic called. The back frame of the car is split in two. "If you had hit one big bump," he said (Hi! We live in the Midwest, where we grow pot-holes as big as Rhode Island! And we had the pot-hole-iest winter ever this year! And many of the roads haven't been fixed yet!) "...you could have punctured your gas tank and..." FIERY DEATH!!! "We don't recommend repairing the car," he went on to say.

I'm so grateful the Lord protected us from an EXPLODING CAR and FIERY DEATH!!!

Oh, Subaru, mostly green (though Aaron thinks you're blue) except in the parts where you got rusty (and Aaron patched you up and painted you... blue), we'll miss you and your 219,000 miles.

Anybody selling a commuter car for cheap?

I See Phelps's 8 and Raise Him 1

That is, if I can set my nine* failed assisted reproduction cycles against his eight gold medals. It's hard to say which accomplishment required more effort, endurance, and sacrifice.

Today's results were negative, in case you didn't catch that.

I'm disappointed and wondering what comes next, but still in faith for whatever the Lord has in store for us.

I read these words this morning before I left for the clinic, words that I want to be increasingly true of me, words that are being worked in me by God through this lingering trial of infertility:

"Whom have I in heaven but you?
And there is nothing on earth that I desire besides you.
My flesh and my heart may fail,
but God is the strength of my heart and my portion forever."
(Psalm 73:25-26)

*ten, if you count the IUI that was converted to timed intercourse due to an insurance requirement being missed

Accept No Gospel Substitutes!

A couple Sundays ago, Tab preached a most helpful message from Hebrews 9:15-28. You can listen to the message here. The main point was that, when it comes to relating to God, there is no substitute for the gospel, the finished work of Christ. We often think of the gospel as a one-time thing, what brings us to God when we first become believers. But the gospel isn't just the gateway of first-time access to God; it's the gateway for our everyday relationship with God. Unfortunately, we're all prone to substitute other things for the finished work of Christ, thinking we need to add to the gospel or move on to something new. Tab highlighted three "gospel substitutes;" I'm going to focus on two of them.

The first gospel substitute is self-reliance. We think there is something we can do, even have to do, that will bring us to God. Do you ever think that, because you didn't make time to pray in the morning, you can't be close to the Lord or get help from him on a certain day? Or do you think that you have to work up some specific emotion in order to connect with God while singing worship? That's the gospel substitute of self-reliance. That's forgetting that faith is not based on our works but on Christ's work. What's the remedy in those times when we think our relationship with God depends on something we do? We have to go back to the gospel. Jesus appears in the presence of God on our behalf (v. 24); he has a permanent place in heaven securing the way to God. We don't have to do anything to relate to God. We simply, completely rely on the access bought by Christ's sacrifice.

The second gospel substitute is self-atonement. This is the highly insidious belief that we have to make up for our sins before we can relate to God. As if we even could! Yet we give into the lie again and again. Here's what it looks like: We sin; then, we think we have to wait to draw near to God until we've stopped sinning. ("I can't pray for help when I still feel so angry at my husband!") Or, we think we have to wait to draw near to God until we feel forgiven. ("Yes, I confessed that sin to God. But he won't really forgive me and help me change unless I feel bad enough about what I've done.") Don't we all think those kind of thoughts? When we do, we're making our own (in)ability to atone for our sins a substitute for the gospel. What's the antidote? We remind ourselves that Jesus has appeared once for all to put away sin by the sacrifice of himself (v. 26). His once-for-all sacrifice leaves no room for any extra sacrifices we try to make to pay for our sins. What joy and freedom this good news brings!

I'm so glad to be at a church where I hear the regular call to accept no substitutes for the gospel. I've needed these truths during a busy season of moving, infertility treatments, and family visits. I'm going to continue needing these truths every day of my life, so that I can keep growing in the grace to rely on Christ and not myself.

Mixed Messages

Last Wednesday, I visited the clinic for a post-IUI scan of my ovaries. The first time I did an IUI at this office, the nurse told me that the purpose of the ultrasound was to see if I was producing enough progesterone. If the ovaries measured above a certain size, that indicated sufficient progesterone production. If the ovaries measured smaller than the desired size, then an HCG booster shot would need to be administered. The nurse I saw this past week gave me a completely different interpretation of this scan and its purposes. According to her, my enlarged ovaries mean that I am slightly hyper-stimulated and that it is not safe for me to take the standard-protocol HCG booster. So according to the first explanation, a bigger ovary measurement is a good thing; way to go, ovaries, no more HCG needed! But according to the second explanation, a bigger ovary measurement is bad news; sorry, no more nice HCG for you. Which is it? I don't know. How much affect does it have on the ultimate outcome of the cycle? I don't know that either. But I'm content to wait and see; I go in for the beta on Monday.

"But as for me, my prayer is to you, O Lord.
At an acceptable time, O God,
in the abundance of your steadfast love answer me in your saving faithfulness."
(Psalm 69:13)

Learning How to Use My "New" Oven

I declared the pork done when it caught fire.

Had I but Internet Enough, and Time

Faced with technical difficulties (a dysfunctional laptop, an Internet connection that spontaneously swapped its user name and password with another account to the bafflement of the good people at tech support) and a full schedule when I wasn't trying to straighten those issues out, I was unable to post last week. Over the next few days, I plan publish the things I wanted to write last week, from the frivolous to the medical to the spiritual, in no particular order.

Laissez-Faire Attitude Exhibit B: I Took My Trigger Shot an Hour Late on Friday and Didn't Get Anxious about It

Thanks to those who prayed for our IUI yesterday morning! The Lord mercifully caused things to go quite smoothly, despite the fact that we were exhausted when the alarm sounded and not eager for the whole IUI process. We didn't have as rushed of a morning as we often experience on IUI day. We made it to the clinic with ample time, and we were even seen early, which meant we could make it to church.

In keeping with my new, accidental laissez-faire attitude toward this cycle, I didn't pay too much attention to the report of the sperm counts for the IUI. They gave me numbers, but I honestly couldn't remember what the ranges are for good motility and post-wash count, and I didn't feel like asking. So the numbers were just... meaningless numbers. I started to look up the information this morning, then I decided that I didn't really have time to search around. Yes, knowing what kind of counts we had for this IUI might give me some idea of what to expect, but simply knowing the numbers and statistics won't affect the outcome of the procedure. So I'll just wait in blissful, distracted-by-settling-our-home ignorance.

As we sang yesterday morning in church:

We offer our lives to proclaim
What a Savior!

Anything can happen with this IUI, as long as it results in a proclamation of the greatness and kindness of Christ.

I Probably Didn't Really Have Time to Re-Write Showtune Lyrics, Anyway

At this morning's follicle check and blood draw, the nurses thought I would likely be on Follistim and Repronex for another day, back for blood and ultrasound tomorrow, then probably scheduled for a Monday IUI. I had run out of Repronex, so I had to "borrow" some from the clinic in case I needed it tonight. On my drive home, I began composing alternate lyrics to the Les Miserables tune, "One Day More," to post as a description of the pending plan. I could hear the different sections - me, the patient, in place of Valjean, the nurses in place of the Thenardiers (no insult to the nurses intended; their instructions just fit the rhythm) - joining in a glorious, swelling medley of assisted reproductive technologies. When I stopped to fill up the tank of my car, I was trying to think of rhymes for "ovary," "Follistim," and "Repronex" - not an easy task. I filed the idea away to come back to after work.

Then I checked my patient voicemail box, and found out that the doctor actually wants me to stop meds, to take the HCG trigger shot tonight, and to come in for the IUI on Sunday. So much for my new Broadway hit! Please pray for us on Sunday morning.

(For those who like the numbers, here's the run-down: two 17mm follicles on the left, a few 13s on the right, and E2 at 1023.)

(Also, it bothers me that I don't have accent marks in the proper places for all the French words and names, but I don't have time to figure out how to do that right now; please imagine little slanted hash marks.)

Courtesy of Unpacking and Search Engines

While unpacking some miscellaneous desk items, I unearthed a post-it note on which I had scribbled some of the odder phrases that led people to my blog through search engines. Without further ado, I present the list.

IVF and pepper (huh?)

OB-GYN Christmas jingles (huh? two times!)

perfect me heart motives (sanctification for pirates!)

entrusted picture dictionary (how would you draw a picture of "entrusted"?)

want to be infertile (trust me, honey, you don't)

arrested development in the emotions of an embryo (I... don't even know what to say about that one)

Those of you who've been following along for a while will be glad to know that people are still stumbling upon my site when looking for:

chicken reproductive system pictures

And now, also:

artichoke reproduction system

I hope the chickens and artichokes are more successful at reproducing than I've proven to be!

Oh Yeah, There's More to Our Lives than Home-Ownership

So, not only did we move into our new house this weekend (hello, boxes that are still everywhere!), I also started medications and appointments for a new IUI cycle. A friend who was helping me unpack our kitchen laughed at the initial contents of our new fridge - a large jug of water, a bowl of leftover potato salad (from a night we had spent painting at the house), four boxes of Follistim, and one box of Repronex. Rather telling of our priorities at the moment!

I don't think I've mentioned this yet on the blog, but Dr. Owlish has left the practice (he moved to be closer to family, so I guess I can't begrudge him that). It was disappointing, as we had been so pleased to start seeing him, but we trust God's timing. I've been handed over to the other doctor at the clinic, but I haven't actually seen him yet (and may not for some time, who knows?). He's a very respected doctor in the field, nationally, so I assume I'm in good hands, but I don't know if we will click with him personality-wise in the same way we did with Dr. Owlish. Anyway, the new-to-me RE reviewed my charts from the cycles I did with Dr. Owlish, and he decided to add Repronex into the medicine mix. I don't really know what it does, but I've been too swamped with all the house stuff to worry about asking. It's another injectable drug, one that I mix myself. Then I squirt the Follistim into the same syringe, so I only have to give myself one shot total instead of one for each medicine. It makes for a lot of needle juggling, especially once I've sterilized things and don't want to set them back down! I've taken this combination of meds for three days now, and a check-up today showed dozens of small-to-medium follicles on each side (the largest were 13, 12, and 10 mm) and an E2 level of 202. I'll continue the same doses (75 IU of Follistim, 37.5 IU of Repronex) for three more days and go back for ultrasound and bloodwork on Friday.

It's kind of strange to have infertility treatments feel like an afterthought, amidst all the business of settling our new home, but I'm grateful for the temporary shift in focus. I pray, of course, that the upcoming IUI will be successful, but I have such abundant evidence of God's kindness all about me right now that it's easy to trust him for the future. No matter what happens, I know that he has positioned us well for whatever will come next.

Look at That! My House Matches My Blog

Here are some pictures of our house! We put in some long days of work on it over the weekend. This week, we have contractors in to work on the basement and the hardwood floors. We move in on Saturday. I'll post a variety of before and after pictures of the interior soon.

After More Delays and Obstacles Than I Would Have Thought Possible

We're buying a house this afternoon!

What are you doing today, big or small?

$50,000 to $0: How We Did It

(Grab a cup of tea; this is a long one! I'm answering the questions about how we paid off our debt as a Works-For-Me-Wednesday post.)

Thanks for all the congratulations on paying off our debt! Several asked how we did it. It began when, a little less then a year into our marriage, our church hosted a Money Wise Workshop*, given by Tom Werth (now on staff at CrossWay Community Church in Kenosha, WI). At the time, ironically enough, Aaron had just lost his job, so we couldn't begin to apply much of the information until a few months later when he had full time work again. Still, we gained a conviction that being debt-free wasn't just preferable but biblical, and we learned some practical tips to send us toward that goal.

We had a credit card balance from our honeymoon, a handful of student loans (mine were consolidated, Aaron's weren't), and two car loans, all adding up to about $50,000, as best as I can remember. We didn't have a large income at all; that year, our combined earnings were about $45,000. I share that to encourage you that it can be done, even without a huge cash flow.

As our first step, we set up a thorough budget, based on our income after taxes and giving to our local church. We cut out just about every extra - clothes, eating out, etc. During that time, we asked our family, in lieu of regular birthday and Christmas gifts, to give us gift cards to favorite stores and restaurants; that helped to give us little splurges that we couldn't otherwise afford. We did what we could to keep our living expenses to a minimum (affordable rent on a small apartment; the most basic phone plan; no internet at home - we used the library; a strict grocery budget that sometimes meant we ate nothing but eggs, pancakes, and pasta at the end of the month).

Once the budget was in place, we asked some financially-sound friends to help us make a plan to pay off our various loans. They gave us some advice that actually went counter to some of the conventional wisdom but that worked well for us. For instance, one recommended that we pay our credit card off before starting any "emergency fund" type savings; his reasoning was that the interest rates on a savings account were so much lower than the interest we were paying on our debt that we would actually lose money by saving. So we paid off our credit card first, as quickly as we could, then started an emergency fund (the standard 3-months-worth of living expenses) to save for things like car repairs, job loss, etc. Another friend (and a CPA to boot) recommended that, rather than following the course of paying off the loan with the highest interest rate first, we pay the loans off essentially from smallest to largest. This had a huge impact, because we were able to quickly escalate payments on each loan.

Here's how that worked: Aaron had one small student loan (about $1000, I think) for which we only paid about $10 per month. We paid up on that as much as we could and were able to pay it off fairly quickly. Now, we rolled that $10 a month into the payment for the next loan, another small student loan on which we owed $30 per month. That one was paid off fairly quickly, too, and it motivated us quite a bit to see the progress of having two fewer bills to pay. We added $40 per month (the combined amounts from the two loans now paid off) to a car payment, meaning we paid something like $190 per month instead of the required $150. It took a while longer, but after we paid off that car, the snowball effect of the cumulative payments really took off. By adding the now freed up $190 per month to our other car payment (which was set at $175), we paid that car off in half the time of the 5-year term of the loan. At that point, we turned to tackle our two largest student loans (originally about $13,000 and $20,000 respectively). Again, adding all the previous payments no longer owed to the monthly payment on those loans (one at a time), we paid about $450-500 per month toward the first loan, and eventually about $1000 per month toward the second loan. We couldn't always make the big payments (like at Christmas-time, when we had extra expenses in the form of travel and gifts), but we paid as much as we could every month, and the effect was enormous!

During that whole process, we used any unexpected windfalls to pay whatever loan we were targeting at the time; tax refunds, Christmas bonuses, and the like took big bites out of those loans. We started out paying off our loans with very slow, small steps, but eventually we could take long strides and pay down debt quickly. When we began, our debt seemed insurmountable and I felt we'd never be done with it; but it only took five years!

As our income increased over time (although we still make a very moderate living) and our debt decreased, we were able to build non-essentials back into the budget, although we still keep those to a minimum (i.e. $50 per month for clothing, $60 per month for eating out). We don't buy things unless we have cash in the bank for them, and we use debit for most purchases. The only occasional exception is travel; we might put part of a vacation on credit, but we determine to pay off the balance within a month or two at the most. Once we take on a mortgage, we'll have to tighten the budget again, but now we know we can do it, by God's grace. We certainly couldn't have stewarded our finances this way without help, and I hope that by sharing these details some of you are helped, too!

*It looks like you can download the seminar audio and workbook for this workshop from our related church, Covenant Life, here.

"Madness" and "Craziness" Are the Two Words Most Frequently Uttered in Our Household Right Now

I'll spare you the details, but here's a status report from the past week of our efforts to buy a house.

Tuesday: We think the sale will fall through.

Wednesday: We might get the house!

Thursday: We think the sale will fall through.

[Insert holiday weekend.]

Monday: We might get the house!

Tuesday: Negotiations are still up in the air, but we're engaged in a mad scramble to pull everything together to possibly close next week.

Please pray for us!

Approximately $50,000 to $0 in 5 Years

As of today, we are completely and gloriously debt free! We just paid off the balance of our last school loan, so now we have no education debt, no car payments, no credit card balances, no mortgage, nothing owed to anyone. We're so grateful for the teaching we received early on in our marriage about the principles of financial stewardship and for the money-savvy friends who helped us put together a practical plan to pay everything off as soon as possible. Thank you, Lord, for providing!

Orange-Avocado Salsa

For the Five-Ingredients-or-Less edition of Works for Me Wednesday, I thought I'd share this orange-avocado salsa, a summer favorite of ours. We like to serve it over grilled chicken breasts with rice, but I bet it would be tasty with fish or pork chops, too.

Orange-Avocado Salsa

1 tbsp lime juice
1 tsp honey
2 large navel oranges
1/4 cup finely chopped red onion
1 avocado, pitted and diced*

In a medium bowl, whisk lime juice & honey together. Season w/ salt & pepper (I know, those weren't on the ingredients list, but that would have made for seven ingredients rather than five; shhh!). Set aside.

Cut up the oranges: Slice of both ends of each orange. Following the curve of the fruit, cut away the peel and pith. Quarter the oranges (basically, cut an X lengthwise through the core of the orange, if that makes sense), then lay each half (two of the quartered sections) flat and slice sections 1/4" thick; this will give you a bunch of little orange triangles.

Add orange pieces, onion and avocado to honey-lime mixture. Toss gently to combine. Serve immediately.

*This may be obvious, but here's how I dice an avocado. Use a chef's knife to cut the avocado in half vertically, curving around the pit. Separate the two halves, then whack the pit with your knife (this is why I use my big, nicely weighted chef's knife for this task); twist to remove pit. Now, cut 1/4-1/2" dice into each avocado half, without slicing through the skin. Use a spoon to scoop the dice from the skin of each half. Nice and neat!

Progressing Towards Home

We were finally able to get a variety of professionals in to the house at the end of last week. That process was a comedy of errors that felt more like a tragedy at the time - locks changed on the house so we couldn't get in for the first appointment, miscommunication about the rescheduled appointment so that we weren't all in the same place at the same time, and so on. The realtor, an air tester, an HVAC professional, a mold assessor, and I all managed to converge on Friday. Conclusion? The furnace, which wasn't working at our original inspection, was repaired by the seller; it's still an ancient, inefficient piece of machinery, but it's safe and it works. The air test showed the presence of mold spores common after basement flooding, but it's not toxic and the levels aren't too high; it still needs to be addressed, but it's not a major health hazard. And the mold assessor judged that the only areas of the basement that definitely need remediation are the bathroom and storage area, although we asked for a quote for the whole basement to be safe. All in all, we feel much better having a more realistic picture of the works that the house needs, and we were reassured to find out that not everything has to be done up front. We're asking the seller to remediate the mold, so please pray that those negotiations go well (and quickly!) this week. If we reach an agreement on that, and if Aaron and I feel like we're not taking on too many future projects, then we'll move forward. I'm ready to be done with this whole process!

For we know that if the tent that is our earthly home is destroyed, we have a building from God, a house not made with hands, eternal in the heavens (2 Cor. 5:1).

One Item Checked Off the Wait List

NO nine-month wait added to that list. The nurse just called with negative results for the IUI cycle. I had such low expectations that I'm really not disappointed at all. We're going to take July off, because hopefully (please, Lord?) we'll be moving. And I probably have cysts anyway, but we won't bother to check this time. On the bright side, now I don't have to worry about a pesky due date interfering with a trip to Hawaii that my family has planned for March 2009. That's a nice shiny silver lining, huh?

Quick Update

This has been a week of waiting. Waiting to get results for the IUI next week. Waiting to hear back from the seller of the house. This morning, we finally got official approval from the seller to bring in a professional mold mitigator to give an estimate about how extensive the mold is (the inspector only saw a little bit in the corner of the basement bathroom) and how much it would cost to take care of it. So we called our inspector to ask for a recommendation for a mold remediator; he wasn't in, so I left a message, and now we're... waiting.

I'm trying to remember that I'm waiting on the Lord, even though it feels like I'm waiting on people.

Meditation on Psalm 31

I wrote this reflection on Psalm 31 in my journal on Wednesday morning, after all of Tuesday's challenges. (It will have more context if you read the Psalm first.)

Lord, rescue me! Under the weight of all of yesterday's disappointments - the low counts for the IUI, the refusal of the seller to do any repairs on the house - help me to take refuge in you. I know you have already delivered me from my sin; now please deliver me from these trials! Hear my pleas! Remove the shame of having all my desires squelched. Help me to trust that you lead and guide me through infertility and home-buying for your name's sake. Help me to hate the sin in my heart that makes children and houses into idols. Remind me that you are not indifferent to my affliction and distress, but you are gracious. When my eyes are tired of crying, when my soul and body are weary of difficulty, when I feel like all I have are sighs and sorrows, remind me that you are a strength for the weak. You are a sympathetic high priest. You have taken the burden of my iniquities; you made this enemy your friend. You are kind, even when I have a hard time seeing it. Help me to rejoice and be glad in your steadfast love.

God, give me confidence that you have goodness stored up for me. Right now, in my unbelief, I expect abundant hardship from your hand. I believe the reverse of the Savior's words about your Fatherly love - I feel like I am asking for bread and you give me stones, for fish and you give me a snake... Or rather, for a child and you give me infertility, for a house and you give me a moldy basement and a rusty furnace. Conquer my unbelief! Cause me to fear you and take shelter in you and to expect good from you.

Setbacks

Tuesday was challenging.

The IUI went okay. Everything about the procedure itself happened as usual. However, Aaron's numbers were below the preferable range for IUI (motility 31% instead of 50% or greater, a count of 9 million - I think - instead of 10 million or greater). The nurse said the numbers weren't bad enough to cancel the IUI, but... momentary silence implying that we shouldn't get our hopes up... So we'll see. I have an ultrasound tomorrow to check if my ovary size indicates adequate progesterone production, and then we wait until the end of June to test for pregnancy. I know our God is bigger than any statistics, but if the conditions of this IUI are less favorable than our previous five - well, less favorable than a whole batch of negatives equals a pretty poor prognosis of success.

Then, we had bad news on the house front. You may remember we've been waiting to hear back in negotiations with the seller to take care of some relatively major issues (water damage, ancient furnace, etc.). Late Tuesday afternoon, the seller (or rather, her lawyer) sent a two-sentence letter "respectfully" declining to do any of the repairs we requested. I was bitterly disappointed. I've been trying to prepare my heart for a potential negative outcome and trying not to idolize this particular house, but the groundwork I laid crumbled almost immediately. The door hasn't completely closed on that home; we did hear a new development from the seller's lawyer today, and we're going to get some professional estimates on the work that needs to be done before we make any final decisions. But it's certainly not turning out to be a straightforward process.

So I've been weary. I'm battling unbelief, and I'm disappointed to see how my heart is growing to expect difficulty from the hand of God rather than blessing. (Honestly, my first thought upon getting the IUI and house news in the same day was, "What next, Lord? Are you going to cause one of our cars to explode? What else will you make go wrong?") I know that he will work this all for my good, and I know that all these things that feel like Plan B to me are part of his best purposes. But right now, I'd like to trade in my Person Who Grows Through Hardship badge for a membership in the People Who May Not Learn A Lot But At Least Life Is Easy club.

No Menopausal Nuns Were Hurt in the Making of this IUI ::updated::

When the nurse called with the results on Friday afternoon (E2=285, follicles measuring 15, 13, 10, and 9 mm), she told me to come into the clinic again on Saturday morning for more bloodwork and another ultrasound. At that appointment (to which I rode my bike), C-Pug declared, "Your lining is gorgeous!" My follicles measured 18, 15, 11, and 9 mm, and my E2 had gone up to 495. The doctor instructed me to take one more dose of Follistim on Saturday night, and then I took the HCG trigger shot last night. The IUI is scheduled for 10 a.m. tomorrow (Tuesday) morning. Please pray!


(For those who don't spend all their time immersed in the world of infertility terminology: E2 is a specific estrogen which should reach levels of 200-600 for every mature follicle; a mature follicle (the sac in which the egg grows) is 18mm or larger; HCG is human chorionic gonadotropin, a pregnancy hormone (the medical form is derived from the urine of pregnant women and menopausal nuns) that mimics the effect of another hormone (luteinizing hormone, or LH) which induces ovulation; IUI is intra-uterine insemination.)

::update::
(As I mulled over this post later while I drove around on some errands - what? doesn't everybody do that? - I realized that I gave inaccurate information in my parenthetical note at the end. It's actually follicle stimulating hormone, or FSH, I think, that comes from the urine of menopausal nuns. Which makes more sense. How would menopausal nuns secrete HCG? Anyway, the title of the post still holds.)

Cycling... and Cycling

I had my second ultrasound and bloodwork appointment for the current IUI cycle this morning; I'll get all the numbers (follicle measurements and estradiol levels) this afternoon, but the ultrasound tech said everything looks "gorgeous" - apparently, her favorite adjective, since she uses it every time I see her - and that things are really growing. This particular ultrasound tech is really darling, so I hereby decree that I will nickname her Cutie-Patooty-Ultrasound-Girl, or C-Pug for short. By the way, my protocol, for any who are curious, is 75 IU of Follistim per day (a lower dose than my last cycle, and I think this will work much better for my production-happy ovaries).

So I have two weekend assignments for you:

1) Both Monday and today, I rode my bike to the clinic. It's only a 20-25 minute ride each way (as opposed to a 10-15 minute drive) on a nice route between our apartment and the hospital. The nurses had instructed me not to add any new excercises during the IUI cycle, so technically biking isn't forbidden for me, but I'm starting to wonder if it's too much. What do you think? I'm popping up a poll in the right side bar, so go ahead and vote.

2) Legal wheels are still turning on the house stuff post-inspection. But that doesn't stop my mental wheels from spinning with decorating ideas. (I figure, hey, whether we end up buying this home another one, I'll still be decorating something.) So tell me in the comments, what are your favorite decorating and design resources - websites, magazines, books, stores, etc.?

Happy Friday!

Any Way

During the New Attitude conference, my mind filled with memories of how we realized the failure of our first IVF at last year's conference. It was tempting to moan, "Another year past, and nothing has changed!" But that's not true. Yes, my infertility hasn't gone away. I still don't have a baby or even the whisper of a pregnancy. But my heart has changed. God has been at work to make me content and to make his Son more precious to me. And at the conference, primarily through the worship times at Na, another change happened in my heart.

For much of the past three years, I have sought to remind myself that this trial of infertility is not primarily about me but about God's purposes. I have thought, "What glory the Lord will receive when I have children!" I've expected that if I just wait long enough, the end result will be a splashy display of God's kindness when he gives me a baby and everyone around me rejoices in finally, beautifully answered prayers. But now I am starting to think, "What glory the Lord will receive even if I don't ever have children." He doesn't have to give me a baby to glorify himself, to show himself good and beautiful and true. And I'm beginning to see that I will be okay whichever way he chooses to work, whether he shows his mercy and love by fulfilling my desires for children or by enabling me to walk in grace for an entire lifetime of childlessness. Increasingly, I want the title of my life-story to be not Barren Woman Finally Blessed by God with Babies after Years of Patient Endurance but What a Savior. As we sang over and over again at New Attitude:

O Father, use my ransomed life
In any way you choose
And let my song forever be
My only boast is you.

Hallelujah! All I have is Christ.
Hallelujah! Jesus is my life.

Home, Inspected

Here is our layman's interpretation of the home inspector's report: the house has a robustly healthy body, but it's balding and has stinky feet.

The home inspector said that the structure is in excellent shape; it was built really well, and the original footprint and floorplan have not been altered. However, since the house is 80 years old, it does have some problematic issues. The basement has had some flooding and needs waterproofing and mold mitigation, the furnace is 30 years old, and the roof is about 15 years old (though not leaking anywhere). The inspector gave us very rough estimates about how much it would cost to do the necessary work, and it was all less than we would have expected. They're three big jobs, but they're doable. So now we move into negotiations with the seller. We're hoping that the seller will take care of the flood damage and the furnace (our realtor thinks the current owner might have a home warranty, which would cover some of that); we'll ask about the roof, too, but we're willing to save up to do that ourselves if need be. We still really like the home, and we want to make it work, but we're holding it very lightly. Lord willing, we'll come to a good agreement with the seller and will still be able to make this home our own soon. Please pray with us to that end!

Six One, Half Dozen the Other

Today marks the start of my sixth IUI cycle. I have mixed feelings about that. On one hand: Yay! Cysts are gone! Another chance to get pregnant! On the other: Hmph. Six IUIs; really? How did I get to be that person, the barren woman with a litter of failed infertility treatments in her wake? Counting our two IVF attempts in with all these IUIs, and it won't be long before my medicated cycle counts number in the double-digits. When do we just say, "Enough," and move on? I've started to have thoughts like, "If we had started to pursue adoption when we realized we were infertile, we might have a child or even two by now." But here I take comfort in God's sovereignty; we've sought his will, he's led us down this path of medical intervention, and he will build our family in his way and time. All those "what if" questions are fruitless; I only need to trust that God is good and he is in control.

So, IUI #6, here we come. I start the Follistim injections today (I think; I need to get a call from the nurse to confirm my instructions), and the actual IUI will probably fall mid-June.

Please, Lord, let this one work.

Endorsements of the House in O_______ that We Will Most Likely Buy, Pending Home Inspection and Such

"That's the most beautiful house in the universe!"
- a 6-year-old nephew

"You could turn the garage into a nice potting shed."
- mother-in-law and former president of the West Virginia State Garden Club


(We did, in fact, place an offer on the 1930's bungalow-ish house in the town* on the river, and the seller countered with exactly the price we had hoped to pay. So we have a contract, pending various legal and financial approvals. Home inspection is Monday; please pray no major snafus come to light. We really love the house!
*You may have noticed that I'm borrowing a device from Jane Austen and referring to the town by its first letter only. If you live near us, you can probably figure out which town the house is in, but I'd rather not have the whole Internet know where to find us!)

Piping Through Some Links

I'm still trying to return to life as usual after the Na conference, so instead of coming up with original blog material, I'll pass on a few links to content I've appreciated over recent weeks. Each comes from a different member of the Piper family.

From Molly Piper - How to Help Your Grieving Friend, a series of practical tips gleaned from her experience after her daughter Felicity was stillborn last fall

From Abraham Piper - 12 Ways to Improve Your Blog by Serving Your Readers

From John Piper - How a Roman Catholic Anti-Calvinist Can Serve Today's Poet Calvinist, an intriguing tribute to one of my favorite books, G.K. Chesterton's Orthodoxy. Here's one quote from the essay: "One of the reasons that Calvinism is stirring today is that it takes both truth and mystery seriously. It’s a singing, poetry-writing, run-through-the-fields Calvinism." (HT Justin Taylor)

Now, I'm off to eat dinner with my in-laws...

Greek Chicken Kebabs

My pal from In Search of Morning Sickness reminded me recently that I haven't posted a recipe in a while. I tried a new recipe recently for Greek kebabs, which ended up not being kebabs because I couldn't find our skewers. So here's my modified version:

3-4 boneless, skinless chicken breasts, cut into 1" pieces (about 24)
1 zucchini, halved lengthwise and cut crosswise into 1" pieces (about 16)
1/2 small red onion, quartered
2 tbsp olive oil
1 tsp dried oregano
3 tbsp white or red wine vinegar, divided
1/2 cup crumbled feta
1/4 cup plain yogurt
1 cup fresh mint leaves
salt & pepper

In a resealable plastic bag, combine chicken, zucchini, onion, oil, oregano, and 2 tbsp vinegar; season generously with salt & pepper. Marinate at least 30 minutes or up to overnight. Preheat broiler; place rack 4-6" below heat. Line a roasting pan or rimmed baking sheet with foil. Toss marinated chicken and vegetables onto prepared pan. Broil, turning at least once, until chicken is cooked through, about 15 min. Meanwhile, make dipping sauce. Blend feta, yogurt, mint, and remaining tbsp vinegar until smooth.* Serve chicken and vegetables over rice, with dipping sauce.

If you can find your skewers, you can thread the chicken, zucchini, and red onion onto them, in alternating fashion, and then grill them for about 15 min.

Happy Memorial Day weekend! I'm going to the New Attitude conference, and I'll resume posting when I get back.

*I used my immersion blender and its handy measuring container accessory for the sauce. I love this tool! If you don't have one, a food processor will work just fine for making the sauce.

A Calcium Supplement for Osteoporosis of the Soul

As part of my current Bible reading plan, I am in the book of Proverbs. I recently read a verse that gave me a chance to reflect on how much spiritual fruit God has graciously brought about in my heart over the course of this trial of infertility.

A tranquil heart gives life to the flesh, but envy makes the bones rot (Prov. 14:13).

I remembered how, a year or two ago, this verse arrested my attention. Jealousy of friends who were pregnant or had children was a daily struggle at the time, and this verse helped me to see how very serious my sin was. It also aided me to choose what to think when those moments of temptation to envy surged. I mean, given the options of rotting bones or life-filled flesh, the decision is pretty obvious! The words of this verse spurred me on to pursue the tranquil heart that comes from trusting God even when other people's pregnancies and babies lay like large fallen trees across my trail. Reading this verse again encouraged me so much, to see how the Lord has given me grace to put the sin of envy to death. I certainly haven't attained a heart perfectly free of the green monster. But I have gradually learned to tune out the voice that says I should resent my friends for having the blessings I want and to tune in to the glorious channel that broadcasts the blessings I have in the gospel. I am so grateful for this more peaceful state!

Earlier this week, I was emailing with a friend about the sin of jealousy, and I was reminded of a couple of resources (in addition to the Proverbs verse) that have helped me in the battle. One is a post from the GirlTalk blog, "A Battle Plan for Fighting Envy." The other is an article from Tim Challies' blog, "When the Critics Rave, I Weep" (this one is loaded with excellent quotes). I thought I'd share these links today as an encouragement to anyone else who is fighting jealousy along with me.

I Have a Little More to Say Now *updated*

So, here's what's happening on the house front. We first went out to look on Monday morning, thinking we'd get a gradual start. On the way to meet the realtor, we prayed to find a home that would serve for hospitality and outreach. We didn't like much of what we saw that morning, and the one house we did really like was in a neighborhood that didn't feel completely safe. We hadn't completely ruled it out, and we knew it would probably sell fast (by far the nicest thing in that price range), so we felt suddenly compelled to look at other homes as soon as possible in order to compare.

So, we set up an appointment to see a house in another town on Wednesday evening; that one was gorgeous outside but severely disappointing inside - it really would have needed to be gutted and entirely remodeled. At that point, I felt pretty discouraged. I thought looking at homes would be so fun and exciting, but instead I felt frustrated and anxious that we wouldn't find anything appealing that we could afford. I had to constantly tell myself that the Lord had the right home for us and would lead us to it.

Then, we went out again on Friday afternoon. Aaron almost couldn't make it because of last-minute work complications, but he did manage to meet me and the realtor before we left the first home. That day, we found three homes that we could picture ourselves living in! One ended up having a contract on it, so right now we're down to two options that we really like, both in the downtown area of a cute town on a river. We've placed a long-shot offer on one (our first and maximum bid is significantly under the asking price); it's a two-story frame house built in 1920, all updated inside and nicely landscaped. If the seller of the first house doesn't accept our offer, we'll bid on the second home, a bungalow-ish house built in 1930 that has great bones but would need some updating inside and out. And maybe neither will work out, but I have faith that we'll find a good home soon. Exciting stuff!

edited to add: as we pretty much expected, the seller of home option #1 wasn't willing to work with our offer; we're working on cobbling together an offer for home option #2, and I'm feeling lots of anticipation about this one!

Range, Range on the Home

It's been a quiet week here at Chez Entrusted. Why? Because Aaron and I are house-hunting, and the search for Chez Patterson has absorbed all my time and mental energy. And that's all I have to say about that.

Another Way of Escape I'm Not Going to Try: Closing My Eyes, Sticking My Fingers in My Ears, and Singing "La La La La"

Infertile women worldwide are currently hovering in dread of the weekend. This Sunday is the Day That Shall Not Be Named. When all the moms in church are asked to stand and be honored, I will be tethered to my seat by the short cord that feeds electricity to the neon sign on my forehead flashing, "Not a Mom! Not a Mom!" Or at least that's what it feels like. Every year as the second Sunday of May approaches, I start to imagine scenarios that would excuse me from church for just that one day - sickness, vacation, or at least a sudden need for a bathroom break conveniently sandwiched between singing and the sermon. A long bathroom break. On the other side of the building.

But ladies, we have a better escape route than running away from the Day That Shall Not Be Named. Can I paraphrase 1 Corinthians 10:13 for us? No temptation to self-pity, envy, or anxiety has overtaken you that is not common to women (yes, even the fertile ones). God is faithful, and he will not let the second Sunday in May tempt you beyond your ability, but on the Day That Shall Not Be Named he will also provide the way of escape, that you may be able to endure even a holiday that puts the spotlight on your heartache and yearning by celebrating the women who have what you don't. That way of escape looks different for each of us, but I can tell you this: I'm going to run to Jesus, and not to the ladies' room.

Last week, I shared with a friend how weary I felt after learning that the trial of infertility had not yet come to an end. She encouraged me with Hebrews 12:3.

Consider him who endured from sinners such hostility against himself, so that you may not grow weary or faint-hearted.

What gospel-motivated grace to persevere! When I feel weary and faint-hearted, I need to consider my Savior. He endured the cross for the joy set before him (see the preceding verses in Hebrews 12), the joy of victoriously reconciling people to God through his death and resurrection. He endured those who beat him and mocked him, though he had done nothing to deserve such a punishment. I was one of those hostile sinners until he saved me. My sins are so much worse than any of my sufferings, and yet Christ shed his blood to pay for my sins. Considering the One who endured such enmity and such pain in my place gives me a second (or two-hundred-and-second) wind to keep running, even when infertility sometimes leaves me feeling breathless.

Random Things Come in Threes

Veronica of Toddled Dredge tagged me for a post that lists three random things about me. (And how honored am I to be tagged by one of my favorite bloggers?) Without further ado, here's the list:

1) In my junior year of college, I thought I wanted to go on to get my Ph.D. in literature and become an English professor. In my junior year of college, I met Aaron. As we prepared for marriage, we decided that graduate school wasn't the best option because we wanted to be young parents. Yeah, that's gone really well. Ironically, I could have completed a doctoral program by now. However, I don't regret the choice I made (especially since we're now this close to paying off all of our school loans).

2) This is only indirectly about me, but I've had the opportunity to re-tell this story in the past few weeks, so it's fresh on my mind. My family comes from the Netherlands, and my grandparents still lived there at the time of WWII. (My mom was born at the end of the war, and the family moved away shortly afterwards.) My grandparents lived on a farm, and my grandfather (not the one that recently passed away, but the one still kicking in Texas) was the village carpenter. The family used their farm to hide some people from the Nazi army (mostly young men in danger of being conscripted by the enemy, but also a rabbi). As the German invasion approached, the townsfolk came to my grandfather and asked him to use his carpentry skills to hide all of their valuables (paintings, jewelry, etc.). At the end of the war, everyone returned to my grandpa to find out where their belongings were. He said, "You've been sitting on them every Sunday." He had built false bottoms to all the pews in church and stored all the valuables there. It wasn't until the 1990's that my grandparents shared these stories with any of their children or grandchildren.

3) Veronica mentioned in her list of three random things that she enjoys meat with sweet sauces. I actually dislike sweet-flavored meat dishes. The combination of tastes seems wrong to me somehow, as if they stay too distinct rather than blending together. I much prefer savory meat recipes, with garlic or onions and a decent dash of salt.

I'll tag some new blog friends: Mya, Jill, and Brenna (who is not a new friend but has a new blog).

Swell

The beta on Monday confirmed what we already knew on Sunday - negative. I'm disappointed, of course, but seeing that sadness and satisfaction in Christ can co-exist. If continued infertility is how God is going to receive the most glory from my life, I'm resigned to persevere in this trial.

So today I went in for my CD3 ultrasound. I warned the nurse that I expected cysts, as I've ended up with anywhere from one to four cysts after almost every single previous medicated cycle. The nurse sweetly said that she chose to think I'd be cyst-free this time around. But this morning I blew my own record out of the waters. As soon as the nurse began the ultrasound, she murmured in shock and asked if I was in any pain. Then she started typing measurements. A lot of measurements. Just guess how many cysts I have.

TWELVE.

Eight on the right ovary, four on the left, some as big as 4 cm.

I'm an ova-achiever. (Ba dum bum CHING.)

So now I've got a prescription for BCP to suck the life out of all those cysts. Hopefully, they'll all be gone by my next cycle so that we can do another IUI in June. In the meantime, I think I'll enjoy the recovery break, and I'll avoid any twisting, jumping, or abdominal exercises!

Yesterday

Yesterday, I woke up feeling anxious. One day to go until the blood test that would reveal the outcome of this IUI cycle.

Yesterday, I served in the nursery at church, holding someone else's fussing baby in my arms, standing and swaying until she calmed and slept. As the weight of her warm face pressed into my shoulder, wistfulness swelled and sighed in my heart.

Yesterday, I witnessed several young persons profess their faith in Christ and be baptized. Moms cried happily, dads proudly joined our pastors in lowering their children into the waters and raising them up again, and tears silently rolled down my cheeks as I wondered if we would ever have the joy of having children, of seeing them come to know the Savior and join his bride, the church.

Yesterday, I started to bleed.

Yesterday, Jesus Christ was the same, a rest for the weary.

Today, Jesus Christ is the same, God with me.

Tomorrow, tomorrow, and all my tomorrows, Jesus Christ will be the same, my only hope and peace.

Contentment, Drift, and the Good News

As I wait for the results of this IUI cycle, I continue to be grateful to God for the contentment he has given me even in the middle of trial. But I've discovered that contentment is accompanied by a danger; I'm no longer quite so aware of my need for God. Where I used to urgently search for daily truth and grace to sustain me in the midst of difficulty, I lately have read Scripture and prayed with a sense of complacency. At church last Sunday, the message from Hebrews 2:1-4 spurred me on to guard against the danger of drift by paying "much closer attention" to the gospel. One of the application questions for the message was, "How do your affections for the gospel compare to where they were three months ago?" That question convicted me. My hard-won contentment was born out of gratitude for the gospel, but while the contentment has lingered, the cross-centeredness had not. So I have purposed, as I spend time with the Lord each day, to look more intentionally for the good news that Christ died for my sins.

Good news wasn't too hard to find in my reading in Ephesians this morning!

"But God, being rich in mercy, because of the great love with which he loved us, even when we were dead in our trespasses, made us alive together with Christ - by grace you have been saved - and raised us up with him and seated us with him in the heavenly places in Christ Jesus, so that in the coming ages he might show the immeasurable riches of his grace and kindness towards us in Christ Jesus" (Ephesians 2:4-7).

What a celebration of the precious gospel! God is rich in mercy towards me, not stingy. Why? Because he loves me with a great love! And why does he love me? Not because of anything inherently lovely in me. I was dead in my sin, so it was as though God's love wooed a corpse. But his love is strong enough to raise the dead; he made my soul alive with Christ. What a salvation! And not only did he resurrect this dead sinner, he has given me a place with Christ in his glory, an inheritance with the heir of the universe. All this God did so that he could show me the vast wealth of his grace and kindness. All his bounty is passed on to me through Christ. Content with my lot? How can I be less than content with the riches of the gospel at my disposal?

A Letter from OfIRM to Mr. Aaron Patterson

Dear Sir,

We here at the Office for Infertility Repercussion Management (henceforth OfIRM) regret to inform you that your wife has turned into a snail. This unfortunate side effect of the progesterone suppositories is marked by a distinct trail of slime* left wherever she goes. While strict clinical studies conducted by OfIRM have proven that women taking fewer than two(2) suppositories per day are at no risk of becoming snails, a dose of three(3) or more daily suppositories has been shown to cause rare cases of gastropodism. Your wife's doctor, considering the risk negligible, prescribed a course of three(3) progesterone suppositories per day. Regretfully, Mrs. Patterson appears to be one of the select group who does, in fact, succumb to gastropodism. However, we of OfIRM assure you that gastropodism does not necessarily preclude the possibility of pregnancy. (See Exhibits A and B for evidence of the potential concurrence between snails and gestating women.) Gastropodism is not a permanent condition; upon discontinuation of the progesterone supplementation, your wife should revert from her temporary state as a snail to her usual human form. In the meantime, should you have questions regarding how to care for your wife as a snail, please contact the toll-free number for OfIRM and request Brochure #SE44898, "Managing Gastropodism: The Care and Feeding of Snails."

Sincerely,
The Employees of OfIRM

*OfIRM and its subsidiaries cannot be held liable for any costs incurred for the cleaning of dining chairs and/or seats in cars as a result of said trail of slime.

Double Chocolate Cookies

What's that you say? You want a super-chocolatey cookie recipe? Well, alright...

Double Chocolate Cookies (makes about 24)

20 oz semisweet chocolate chips, divided
4 tbsp butter
2/3 cup flour
1/2 tsp baking powder
1/2 tsp salt
2 large eggs
3/4 cup packed brown sugar
1 tsp vanilla extract

Preheat oven to 350F. Heat 8 oz chocolate chips and butter in a bowl in the microwave in 20-second increments, stirring between each, until almost melted; do not overheat. In another bowl, whisk together flour, baking powder, and salt. In a mixing bowl, beat eggs, brown sugar, and vanilla on high speed until light and fluffy, about 5 minutes. (Don't skimp on the time beating the eggs and sugar! It makes the difference between thinly spread, crumbly cookies and perfectly round cookies with a soft center and a meringue-like exterior.) Reduce speed to low; beat in melted chocolate mixture. Mix in flour mixture until just combined. Stir in the remaining 12 oz of chocolate chips. Drop heaping tablespoons of dough 2-3 inches apart onto baking sheets. Bake, rotating sheets halfway through until cookies are shiny and crackly yet soft in centers, 12-15 minutes. Cool on sheets 10 minutes; transfer to racks to cool completely.

Oh, yum.

Vigilante of Heart

"Keep your heart with all vigilance, for from it flow the springs of life." Proverbs 4:23

In his commentary* on this verse, D.A. Carson writes, "In contemporary Western symbolism, the heart is the seat of the emotions. But in the symbol-world of Scripture, the heart is the seat of the whole person. It is closer to what we mean by 'mind,' though in English 'mind' is perhaps a little too cerebral. So 'guard your heart' means more than 'be careful what, or whom, you love' - though it cannot easily mean less than that. It means something like, 'Be careful what you treasure; be careful what you set your affections and thoughts on.'"

What do I treasure? What do I most often set my affections and thoughts on? These days, I think a lot about two things: having children and buying a home. Now, neither of those is bad or wrong. They are generally good desires. But when Aaron and I consider whether this is a wise time to buy a house, I have to carefully evaluate whether or not I have placed an undue importance on owning a home. And as I wait for the results of this IUI, I need to diligently examine my heart for any inordinate reliance on a pregnancy to give me joy.

Why should I be so vigilant? Because the heart, as Carson goes on to say, "directs the rest of life. What you set your mind and emotions on determines where you go and what you do. ... If your heart is ardently pursuing peripheral things (not necessarily prurient things), then from a Christian perspective you soon come to be occupied with the merely peripheral. If what you dream of is possessing a certain thing, ...that shapes your life."

I don't want to spend my life occupied with the merely peripheral. Houses and, yes, even children are peripheral. Though having a child and owning a home would both be great blessings, neither is essential to my satisfaction. And neither makes an ultimately worthy goal for my life. I still hope to have children by some means, and I still wish to buy a home when the time is right, but those intentions must be submitted to the aim of knowing and glorifying my Savior. So I guard my heart against treasuring motherhood and home-ownership too much. He loves me without those things, and by his grace I can love him without those things.

"Indeed, I count everything as loss because of the surpassing worth of knowing Christ Jesus my Lord. For his sake I have suffered the loss of all things and count them as rubbish, in order that I may gain Christ and be found in him, not having a righteousness of my own that comes from the law, but that which comes through faith in Christ, the righteousness from God that depends on faith." Philippians 3:8-9

*in the reading for March 17 from For the Love of God, Vol. 2

Super Size

Want to double the amount of traffic to your blog overnight? Apparently all you have to do is participate in Works-for-Me-Wednesday. Holy moley! Welcome to all of you visiting from Rocks in My Dryer.

I had an ultrasound this morning to measure my ovaries post-IUI. Judging by the reactions of the nurses, they are plenty large (I didn't ask for exact size, and I wasn't told). The right is much bigger than the left, which lines up with how I've been feeling. (I suspect a cyst, since I had them with every previous medicated IUI.) No need for the HCG booster shot, and I have instructions to call if I feel any severe pain. For now, me and my progesterone suppositories keep trucking along for the remaining week and a half until the blood test that reveals all. Amazingly, I don't feel any real anxiety or impatience as I wait to find out whether this IUI worked or not; I thank God for his Spirit's work in my heart to that end!

Best! Tank Tops! Ever!

So I thought I'd get in on a little Works-for-Me-Wednesday action this week. What is Works-for-Me-Wednesday, you ask? You can find out here.

Last night at our small group meeting, the gals discussed the topic of modesty. (We based our discussion on this message, in case you're curious.) Now, modesty is a matter of the heart more than anything else, but it is also a very practical issue. As we were talking about the specifics of appropriate appearance, I mentioned these tank tops. I have three of them (white, black, and brown), and I probably wear them five days out of every week. They are perfect for layering; they're long (even on a 5'10" girl like me!), and the neckline is just right, not to low, not to high. Now that the weather is finally starting to warm up, they're also great to wear alone. The fabric is light-weight enough to be comfortable, but not so thin that you need yet another layer underneath the tank. (Because, really, who wants to layer up on a hot summer day?) The tanks are form fitting enough to look feminine, but they aren't too snug. So there you have it, ode on a tank top.

How about you? What item of clothing can't you live without?

IUI Report

Everything pretty much worked out for the IUI this past weekend. My appointment on Thursday morning showed a number of growing follicles - one 15mm, one 14mm, three 13mm, and one 12mm. My estrogen levels had risen to 673, just over triple my previous levels from Tuesday. I knew from the size of the follicles that I wasn't quite ready to trigger yet, and I suspected that Dr. Owlish would want me to come in again on Friday. So before I received my instructions, I went ahead and made a preemptive phone call to the clinic to say that I would be attending my grandpa's funeral on Friday and would be unable to make any appointments that day. The nurse who called back reported that they could work around my schedule and gave me instructions to take a lower dose of Follistim that night, to trigger Friday morning, and to schedule an IUI for Saturday morning. I had a few questions about the protocol (why was I triggering in the morning if I should have had a monitoring appointment that day? why was the IUI only 24 hours after the trigger shot rather than the usual 36?), but after playing phone tag for the whole afternoon, I gave up and decided to just follow orders without getting more information. The HCG shot was not too hard to mix up and take, although I did have a reaction at the injection sight (a quarter-sized red welt) and I felt some unpleasant side-effects for a couple days (slight queasiness, tenderness, etc.). The nurse said that next time, if there is a next time, we can dilute the shot more. The IUI itself was a piece of cake. Since this clinic is so close to our apartment, we could relax at home instead of killing time in the waiting area between dropping of the sperm to be washed and the actual procedure. The nurse who performed the IUI was very gentle; I didn't have any cramping when she inserted the catheter. Then, she actually let Aaron push the plunger to send the sperm on through to the uterus; that was a little strange but also made the whole thing feel a bit more personal and less clinical. (The first word that came to my mind for that sentence was "sterile" instead of "clinical" - but it seems somehow wrong to use that word when describing our attempts to overcome infertility!) So now we're in the waiting stage. I only have one check-up between now and the pregnancy test at the end of the month. With everything surrounding my grandfather's death and funeral (which I'll write more about later), I haven't taken much time to think about the IUI or look ahead to what the results might be. I am asking that this will be the time when the Lord removes the thorn of infertility from us, but for the sake of Christ I am content with these hardships for now.

P.S. Thank you to all of the family members we saw over the weekend who expressed that you are praying for us to have children; it means more than you know to be so surrounded by support.

Quick Update on the Funeral and the IUI

It looks like the potential conflict between the funeral and the IUI has been avoided. My grandpa's funeral will be Friday morning. My next monitoring appointment is tomorrow morning, so even if Dr. Owlish instructs me to trigger tomorrow evening, Saturday would be the soonest we would do the IUI. I guess it's still possible that I would have a monitoring appointment on Friday morning, but I'm not going to worry about that yet. I'm grateful for how it all seems to be working out so far.

Right now, life is in upheaval as we rearrange things in order to attend the funeral. A few weeks ago, I had agreed to watch my nephews and niece for the day tomorrow while my sister-in-law travels and brother-in-law works. So today is my last day of work for the week, which means I'm trying to cram three days worth of tasks into one. We'll try to meet my family for dinner tonight, and then we'll pack. Tomorrow will consist of a lot of juggling, in order to get Aaron's sister to the airport, me to my appointment, our nephews to and from kindergarten and preschool, and ourselves on the road to Michigan as soon as we can after handing the kids back over to my brother-in-law. It's quite hectic, but I'm trying to remember that Christ is in loving control of all these things.

Please continue to pray for safe travel and for the IUI scheduling and all these other tasks not to interfere with the time to be with family and remember my grandfather.

At the Intersection of Death and Life

For everything there is a season, and a time for every matter under heaven: a time to be born, and a time to die... (Eccles. 3:1-2)

My grandfather died today. His death was not unexpected; he was in his late nineties, and he has suffered several strokes in recent years. He had another stroke yesterday, and he passed away this morning. The funeral will be either Friday or Saturday. My dad, mom, and brother fly into Chicago tomorrow, and they'll drive from here up to Michigan, where most of my dad's family live. Aaron and I hope to join them there over the weekend.

However, it's possible that the IUI will be scheduled for the weekend. At my appointment this morning, I had three dominant follicles measuring at 12, 11, and 10 mm, plus a few smaller ones. I'm still waiting for further instructions, but my guess is that I will stim for a few more days and then trigger (usually done when the dominant follicle is between 17 and 20 mm). If the IUI and the funeral end up scheduled for the same day, we'll probably have to choose between them. My mom says that we should opt to do the IUI rather than canceling the cycle, if that ends up being the case, but we're not so sure. I don't know yet what my dad would prefer. It seems so bizarre that we might have to decide either to honor a life that has ended or to take a chance of bringing a new life into the world, but we're trusting God's sovereignty in these matters.

We'd appreciate your prayers, for all of the details related to the funeral and the IUI, for safety for my family as they travel, and for the comfort of Christ in this time of loss.

Ready, Set, Go!

The cycle for IUI #5 has officially begun. I visited the offices of Dr. Owlish for my first monitoring appointment this morning. According to the ultrasound gal, everything (antral follicles, uterine lining, etc.) looks "gorgeous." This afternoon, I retrieved my instructions from my clinic-assigned voicemail box (fancy!). I start with 100 units of Follistim tonight and keep that up until my next monitoring appointment on Tuesday. Let the fun begin! (That may sound strange, considering I'm referring to giving myself daily shots and pursuing procreation in a highly technical and medical manner, but after such a long break from treatments I feel almost giddy about proactively cycling again!)

An Encouraging Reflection

Last night, we had a very encouraging care group meeting. We each answered the question, "How have you seen the Lord at work transforming your heart over the past nine or so months, and what means (circumstances, people, etc.) has he used to do so?" As I thought about how to best summarize the work God has done in me in the past year, these words from Isaiah 26:3 came to mind.

You keep him in perfect peace whose mind is stayed on you, because he trusts in you.

I spent a lot of time last year seeking to stay my mind on the Lord by studying his character. (To direct my study, I used Bible Doctrine by Wayne Grudem and Knowing God by J.I. Packer - very helpful and inspiring materials!) Studying God's character developed a greater personal trust in him. As turbulent circumstances continued to unroll - failed IVFs, changing doctors and diagnoses, a wretched HSG, the laparoscopy, etc. - I experienced a degree of steadfast peace that persisted through everything. I still felt (and feel) sorrow, fear, anxiety, but confidence in the Lord's promised goodness predominates. When I receive bad news or encounter disappointment, my soul now rebounds to God's truth much quicker than it once did. By fixing my attention on the Savior, I find that gratitude for the gospel softens and sweetens any sharp pangs of affliction. This is all a work of God's grace! I can still hardly believe that satisfaction in Christ and ongoing infertility can coexist in my life. It's not perfect, of course, but peace is abidingly present.

How about you? How has the Lord done his transforming work in your heart in recent months?

Hardly Different

Today I visited the offices of Dr. Owlish for a lesson in injections, in preparation for the upcoming IUI cycle. If I had know that I would be watching the same instructional video that I saw back in November of '06 (thanks, handy timeline!), I would have brought popcorn to lessen the boredom a bit. Film-making doesn't really qualify as one of the strengths of the fertility pharmaceutical industry. When I met with the nurse afterwards, I declined her offer to go over all the Follistim instructions again. After three IUIs and two IVFs with the stuff, I think I'm familiar enough with the process. What is new for this IUI is that I will be mixing up my own HCG injection. At my previous clinic, the trigger shot prescribed came in the form of a pre-filled syringe. The prescription sent from Dr. Owlish's office includes two vials - one of powdered drug, one of fancy medical-grade water - and two needles - one to mix the contents of the two vials and draw up the combined HCG concoction, and one to administer the injection. This is definitely the next step in my career as a professional self-shooter-upper. Another interesting difference in protocol between the old clinic and the new is that a few days after the IUI, I'll have an ultrasound to check my ovary size. If the ovaries don't measure up, I'll take an HCG booster shot (half the dose of the trigger) in order to notch progesterone production up. Who knew that there is a direct correlation between ovary size and progesterone levels? Other than that, IUI #5 shouldn't vary too much from IUIs #1-4 - except, very hopefully, in the end result. Right now, I'm just waiting for my next cycle to start, so we can start trying again for the first time in a while.

Upon Review, I Should Have Found a Synonym for Confident that Begins with the Letter "D"

Anti-climactic. Brief. Confusing. Confident. All those words describe Wednesday's post-op appointment with Dr. Owlish.

Anti-climactic because I had already received a call from the pharmacy last week about filling my prescriptions for an IUI with injectable meds. Follistim - check! Novarel - check! An astonishing 63 progesterone suppositories - check! Since the progesterone supplementation will only be required for either the two weeks between IUI and beta (quantitative pregnancy test via bloodwork, for all you fertile laypeople out there) OR for approximately the first trimester of a pregnancy, I can only conclude that Dr. Owlish is supremely optimistic or that I will be using an uncomfortable quantity of suppositories for the two-week-wait. Anyway, the premature pharmacy call told me pretty much all I need to know about the treatment plan now to follow the laparoscopy.

Brief because I waited about an hour for about a 10-15 minute meeting with Dr. Owlish. He must have had a crazy day, evidenced by an untidily askew tie and a demeanor almost opposite of his usual leisurely, let-me-thoughtfully-and-sympathetically-answer-all-your-questions manner. In other words, he seemed rushed and we didn't talk for very long.

Confusing because he blithely brushed past the matter of my bent fallopian tube ("It was clear. HSGs can be faulty.") and instead dwelled on the biopsy of my bellybutton mole (of all things!) ("Not cancerous.") and of the pelvic tissue ("Stage I endometriosis. We got it all out."). There I sat, prepared with all kinds of now moot questions about my tube. The few questions I scrambled up about the endometriosis diagnosis met with limited answers. "It was in my pelvis?" (As in, that's a rather unspecified location, doc; what organs was it on?) "Yeah, your pelvis." "Oh. Okay." Now that I've had three different (and two faulty) diagnoses for our infertility, I feel a bit uncertain and wary.

Confident - that adjective belongs to Dr. Owlish. I continued probing about the endometriosis. "Will it come back?" "Yes, but not for a year, and we're going to get you pregnant before then." Dr. Owlish is supremely certain that I will be pregnant very soon. Which is kind of reassuring, but kind of makes me want to mitigate his assurance by abandoning any optimism I have for an opposing, negative realism. But all in all, I'm glad Dr. Owlish is so determined on our behalf.

I do still have hope that we will conceive soon. If that hope is a full balloon, this appointment let a bit of air out, but the balloon is still inflated and floating. I'm praying for good things and seeking to keep my confidence in the Lord.

I'm Too Tired to Think of a Title, Too (But Look! Alliteration!)

Guess what I did last night? I'll give you a hint. It has to do with #2 on this list. I did have a nice salad for dinner, so by using the process of elimination you'll understand why I am taking myself directly to bed (without a book!) and postponing the update I want to write about my post-op appointment.

P.S. If you're looking for some reading material to while away the wee hours of the morning, I recommend Dorothy Dunnett.